Voting Process

Voting Process for CAQH CORE Operating Rules

Work Groups require for a quorum that 60% of all Work Group participants vote. Simple majority vote (greater than 50%) by this quorum is needed to approve a rule.

Level 3:

Full CAQH CORE Voting Membership

Full CORE Voting Membership vote requires for a quorum that 60% of all Full CORE Voting Member organizations (i.e., CORE Participants that create, transmit, or use transactions) vote on the proposed rule at this stage. With a quorum, a 66.67% approval vote is needed to approve a rule.

Level 4:

CAQH CORE Board

The CAQH CORE Board's normal voting procedures would apply. If the Board does not approve any proposed Operating Rule, the Board will issue a memorandum setting forth the reasons it did not approve the proposed Operating Rule and will ask the CORE Subgroups and Work Groups to revisit the proposed Operating Rule.

*NOTES:

CAQH Board/CAQH does not have veto or voting power over the CAQH CORE Operating Rules.

Any entity that is a CAQH CORE Participant per the CAQH CORE application process has a right to vote on the rules, understanding that at Level 3 only entities that will implement the rules vote on the rules.

Contact CAQH CORE

CAQH CORE Participant Calendar

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How the Affordable Care Act Influenced CORE Certification

CAQH Deputy Director Gwen Lohse explains the important role that the Affordable Care Act played in impacting CAQH CORE Certification and the usage of CAQH CORE operating rules in this HealthPayerIntelligence article.